RISK FACTORS FOR THE DEVELOPMENT OF INFECTIONS ASSOCIATED WITH THE PROVISION OF MEDICAL CARE IN THE PUERPERAS

Identification of risk factors for the development of infections associated with the provision of medical care in the face of increasing morbidity is one of the important tasks of epidemiological surveillance. The purpose of the study was to identify possible risk factors for the development of infections associated with the provision of medical care among puerperas due to the peculiarities of the course of pregnancy and childbirth. To achieve the goal of the study, an experimental and control group was formed from among the puerperas. The experimental group included 147 women who developed a purulent infection within 30 days after delivery. In the nosological structure of the incidence of infections associated with medical care in the experimental group, postpartum endometritis predominated with a share of 75.0±6.8%, 20.7%±6.4% occurred in the areas of surgical intervention represented by suppurations and seam rifts and anterior abdominal wall, the proportion of mastitis was 3.0±2.6% and peritonitis – 1.2±1.6%. The control group, formed by the mechanical selection of each 50 birth history for the above period, its strength, was 300 people. As possible risk factors, the features of the course of pregnancy and childbirth were analyzed. According to the analysis of the features of the course of pregnancy, it is revealed that as a risk factor, prenatal hospitalization in the department of pregnancy pathology for more than 1 day (OR=1.57 CI: 1.05-2.37, RR=1.35 CI: 1.03-1.75). According to the results of the analysis of the features of the birth course, it was revealed that, as risk factors, among the anomalies of the genital activity, uncoordinated contractions (OR=6.34 CI: 1.26- 31.81, RR=2.33 CI: 1.53-3.56); from the number of injuries of the birth canal – cervical rupture (OR = 6.34 CI: 1.04-2.86, RR = 2.33 CI: 1.53-3.56); of the number of invasive interventions – amniotomy (OR = 1.58 CI: 1.03-2.44, RR = 1.35 CI: 1.03-1.77), vacuum extraction of the fetus (RR = 3.10 CI: 2.71-3.54), perineal incision (OR = 1.58 CI: 1.03-2.44, RR = 1.35 CI: 1.03-1.77).